HESI Psychiatric/Mental Health Practice Test
An adolescent female who is admitted with bulimia tells the practical nurse (PN) that she does not have an eating disorder. Which finding should the PN report that is most indicative of long-standing purging behaviors? A) Polyuria. B) Excessive facial hair. C) Dental enamel erosion. D) Elevated blood pressure.
C) Dental enamel erosion.
A male client who is in a minor motor vehicle collision (MVC) while on the job is brought to the urgent care clinic. The healthcare provider prescribes a urine drug screen, but the client repeatedly refuses to provide a specimen. Which action should the practical nurse (PN) implement? A) Collect a urine specimen using a sterile catheter. B) Detain the client in the clinic until he cooperates. C) Document the client's refusal in the medical record. D) Palpate the pubic symphysis for urinary retention.
C) Document the client's refusal in the medical record.
Which part of the client's plan of care is the practical nurse (PN) implementing when plans are used to increase a male client's participation in his own care and social environment? A) Client autonomy. B) The therapeutic community. C) The nurse-client relationship. D) The multidisciplinary mental health team.
B) The therapeutic community.
What is the most prevalent type of elder abuse? A) Neglect. B) Physical abuse. C) Financial abuse. D) Emotional abuse.
A) Neglect.
Which behavior should the practical nurse identify as aggressive in a client who is admitted to the mental health unit? A) Acts passive when personal rights are challenged. B) Uses statements that express feelings of victimization. C) Verbally attacks and demeans peers in group settings. D) Addresses others with Mister or Misses before last name.
C) Verbally attacks and demeans peers in group settings.
What finding should the practical nurse (PN) report to the nurse concerning possible abuse of a child? A) A 4-month-old infant with fever that cannot be consoled. B) A toddler who cries when the father enters the room. C) An adolescent who refuses to speak to a parent. D) A 3-year-old who begins bed-wetting during hospitalization.
B) A toddler who cries when the father enters the room.
A male client who learns his results for HIV is seropositive tells the practical nurse that he is experiencing constant heart palpitations, cannot concentrate, and walks around trembling. What reaction to the diagnosis is the client demonstrating? A) Guilt. B) Acute anxiety. C) Suicidal ideations. D) Disappointment.
B) Acute anxiety.
Which nursing intervention should the practical nurse (PN) implement for a male client who is actively hallucinating? A) Use an authoritative stand to confront the client. B) Ask for permission before touching the client. C) Inform the client that no one else is in the room. D) Place the client in soft restraints if he is violent.
B) Ask for permission before touching the client.
The practical nurse (PN) is taking the blood pressure of a middle-aged male who is involved with his children's sports teams as a coach and referee. While establishing a nurse-client relationship, the client tells the PN that he hires and trains teenagers to work part-time in his restaurant. Which psychosocial developmental stage is the client experiencing? A) Identity. B) Generativity. C) Isolation. D) Stagnation.
B) Generativity.
A male client who believes he has a brain tumor after numerous diagnostic tests that indicate no evidence of organic disease tells the practical nurse (PN), "No one believes me! I have the symptoms: terrible headaches and episodes of blurred vision. Last week I felt weak and even vomited. I'm going to die." Which response by the PN fosters cognitive restructuring? A) "Tell me about your relationships with the significant women in your life." B) "Sharing your thoughts and feelings about death can be helpful." C) "There are other possible explanations for your symptoms." D) "Based on your diagnostic tests results, your concern is unfounded."
C) "There are other possible explanations for your symptoms."
A client with schizophrenia approaches the practical nurse (PN) and says, "The voices are bothering me. They're yelling and telling me I'm bad. Can't you hear them?" Which response should the PN provide? A) "Do you hear the voices often?" B) "Have you been taking your medication regularly?" C) "I can't hear the voices, but I can see that you're upset." D) "Dismiss the voices and ask someone to play cards with you."
C) "I can't hear the voices, but I can see that you're upset."
The practical nurse (PN) assesses a client with a poor self-concept. This client is most likely to demonstrate which behaviors? A) Effective group functioning. B) Accurate, astute perceptions. C) Escalation of anxiety. D) Willingness to accept change.
C) Escalation of anxiety.
The practical nurse (PN) is caring for a female client with borderline personality disorder and a history of self-mutilation. The client tells the PN that another staff member makes her feel angry and unimportant. What priority intervention should the PN implement? A) Tell the client that she will be secluded if she acts out. B) Give the client a reward for expressing her anger. C) Explain that she should cope by doing something physical. D) Ask her if she feels like hurting herself when she is angry.
D) Ask her if she feels like hurting herself when she is angry.
A practical nurse (PN) is interacting with a female client who is discussing her divorce as a stressor. What areas should be explored with the client to gather the most relevant information? A) Affective responses. B) Social responses. C) Physiological responses. D) Biopsychosocial responses.
D) Biopsychosocial responses.
During the admission interview to an inpatient psychiatric unit, the practical nurse (PN) asks a male client who is admitted with depression about recent life events that precipitated his admission. The client remains silent, looks at the floor, and does not answer any of the PN's questions. Which intervention is best for the PN to implement? A) Initiate a conversation about the client's suicidal ideations and plans. B) Describe diagnostic laboratory results to the client. C) Ask the client if he would like to talk to another nurse. D) Record these findings in the medical record under the DSM IV Axis IV.
D) Record these findings in the medical record under the DSM IV Axis IV.
A male client is admitted to an inpatient psychiatric facility after taking hallucinogenic drugs. The client screams threats and begins hitting the unlicensed assistive personnel who is assisting with his admission. Which action should the practical nurse (PN) implement? A) Place the client in a vest and soft restraints. B) Attempt alternative means to calm the client. C) Offer the client a chance to modify behaviors. D) Report the client is a danger to self or others.
D) Report the client is a danger to self or others.
A 20-year-old male client who is admitted to the mental health unit for an adjustment disorder is telling the practical nurse (PN) that he wants to find an apartment, but he is afraid he does not make enough money to move out of his parent's home. Using Erikson's theory of psychosocial development, which developmental stage should the PN explore with this client? A) Physical and social losses. B) Feelings of guilt or frustration. C) Mastery of physical motor skills. D) Sense of freedom in the community.
D) Sense of freedom in the community.
A male client is admitted to a drug rehabilitation program for chronic cocaine abuse. Which nursing problem should the practical nurse consider is the client's highest priority? A) Risk for noncompliance related to chronic drug use. B) Risk for self-violence related to suicidal depression. C) Sensory perceptual alteration related to stimulant drug use. D) Risk for other-directed violence related to underlying personality disorder.
B) Risk for self-violence related to suicidal depression.
What approach is best for the practical nurse (PN) to use when establishing a relationship with a severely socially withdrawn male client diagnosed with schizophrenia? A) Read to the client from the daily newspaper to promote orientation. B) Sit with the client in silence several times a day. C) Ask the client questions about the thoughts that he is having. D) Use therapeutic touch by placing a hand on the client's arm occasionally.
B) Sit with the client in silence several times a day.
A client was admitted with major depressive disorder 3 weeks ago and received a prescription for sertraline (Zoloft) on admission. Today the client self-reports feeling great. It is most important for the practical nurse (PN) to consider which information when implementing care for this client? A) The relationship between the depth of depression and suicide ideation exists. B) The client may be at increased risk for suicide as the depression lifts. C) The medication takes 2 weeks to be effective, so the treatment is working well. D) The client is improving, so discharge planning should be considered.
B) The client may be at increased risk for suicide as the depression lifts.
The practical nurse (PN) is caring for a male client who is admitted for schizophrenia and observes that his thoughts do not flow logically and he uses invented words. How should the PN document this behavior? A) Interacts with others using child-like expressions. B) Uses neologisms and tangential expressions. C) Demonstrates rapid speech while anxious. D) Responds with defensive language to cope with others.
B) Uses neologisms and tangential expressions.
A male client with dementia who lives in an extended care facility is placed in a wheelchair each day and positioned in the hall where he kicks people who walk past him. Which intervention should the practical nurse (PN) implement? A) Move him to a busier hall with more people. B) Ask the client every half hour what he needs. C) Call him by name until he focuses his attention. D) Approach the client from behind to apply a restraint.
C) Call him by name until he focuses his attention.
When the mother of a young child is diagnosed with HIV, she asks the practical nurse (PN), "Who will take care of my children if I die soon?" What response is best for the PN to provide? A) "Surely you have a friend or family member who can help you in this time of need." B) "Where is the father of your children? Surely he will want to help with the care of his children." C) "This is an important consideration, but you may live until they are grown up or even longer." D) "I can see that you are very concerned. Would you like me to call the chaplain to talk to you?"
C) "This is an important consideration, but you may live until they are grown up or even longer."
A female client is anxious about a scheduled diagnostic procedure and keeps asking the same question of every staff person. How should the practical nurse respond? A) Encourage the client to watch television as a distraction. B) Reinforce with the client the need for the procedure regardless. C) Affirm the client's anxiety and ask if she wants to talk. D) Reassure the client that the procedure is performed for others every day.
C) Affirm the client's anxiety and ask if she wants to talk.
A woman tells the practical nurse (PN) that for the past 6 months she has been terrified of leaving home. Whenever she thinks about going outdoors her heart pounds, she shakes and cries, and feels dizzy. Based on these findings, which nursing diagnosis should the practical nurse (PN) consider when caring for this client? A) Fear related to physiologic responses to leaving the home. B) Self-esteem disturbance related to inability to leave home. C) Social isolation related to avoidance behavior as evidenced by inability to go out of doors. D) Altered thought processes related to panic attacks when she thinks of leaving the house.
C) Social isolation related to avoidance behavior as evidenced by inability to go out of doors.
A male client arrives at the mental health clinic and tells the practical nurse (PN) that he is overwhelmed and does not know who to talk to about his life. Based on the client's comments, what aspect of the client's life should the practical nurse explore first with the client? A) Coping mechanisms. B) Problem resolution. C) Support system. D) Perception of the event.
C) Support system.
During a prenatal visit, a client who is in the second trimester of pregnancy tells the practical nurse (PN) that she is using cocaine. What information about cocaine is most important for the PN to provide the client? A) CNS stimulants increase fetal heart rate and intrauterine movement. B) Eat foods high in iron and protein if a decrease in appetite occurs. C) Counseling should be sought to learn alternative coping behaviors. D) Cocaine can cause miscarriage or premature onset of labor.
D) Cocaine can cause miscarriage or premature onset of labor.
A client who is admitted for surgery seems to focus only on his immediate concerns and asks the practical nurse (PN) to repeat everything that is said over again. The client seems to follow directions but asks for assistance when filling out admission forms and checklists. He apologizes to the PN often and says he did not hear all of the instructions. This client is experiencing which level of anxiety? A) Mild. B) Panic. C) Severe. D) Moderate.
C) Severe.
A confused male client who unexpectedly becomes agitated and combative, raises his fist and threatens a female practical nurse (PN) stating that he is going to bash in her face. What action should the PN take? A) Activate the de-escalation response team. B) Administer a PRN antianxiety agent. C) Tell the client his behavior is not acceptable. D) Summon the in-house security guard.
A) Activate the de-escalation response team.
The practical nurse (PN) is collecting admission data for a young man with a history of chronic mental illness who is admitted to the mental health unit. What client information is most important in guiding the PN in data collection? A) Displays aggressive and assaultive behavior. B) Expresses denial to comply with treatment. C) Requests to leave against medical advice. D) States he knows how to fit his diagnosis.
A) Displays aggressive and assaultive behavior.
The practical nurse (PN) is planning care for an adult client who is admitted with depression. According to Maslow, which needs should the PN prioritize in the client's plan of care? A) Safety. B) Self-esteem. C) Physiological issues. D) Psychological issues.
C) Physiological issues.
The practical nurse (PN) is assessing a newly admitted client with paranoid schizophrenia who is hypervigilant and who constantly scans the environment. The client tells the PN, "I saw those two doctors in the hall talking about me." What descriptive terminology should the PN document to describe the client's thought process? A) Echolalia. B) Ideas of reference. C) Delusions of infidelity. D) Auditory hallucinations.
B) Ideas of reference.
A female client admits that she has been battered frequently by her live-in boyfriend over the last year. She tells the practical nurse (PN) they plan to be married and she thinks things will be better since he is always sorry after the battering. What is the best action for the PN to take? A) Assist the client in enrolling in a self-defense class B) Provide information to develop an emergency plan. C) Support the client's hope that the battering will end. D) Emphasize battering patterns usually remains the same.
B) Provide information to develop an emergency plan.
What is the primary purpose for the practical nurse (PN) to use therapeutic communication? A) Maintain relationships. B) Mutually share information. C) Promote growth and change in clients. D) Offer advice, suggestions, and spontaneous messages.
C) Promote growth and change in clients.
A 35-year-old male client is admitted after a suicide attempt. Which action should the practical nurse (PN) implement when interacting with the client? A) Redirect conversations that focus on the topic of suicide. B) Recommend that the client focus on peers rather than self-absorption. C) Encourage the client to express feelings rather than suppress them. D) Discuss the impact that suicidal behaviors have on his family.
C) Encourage the client to express feelings rather than suppress them.
The practical nurse (PN) is answering questions that the mother and her teenage daughter who is admitted with anorexia nervosa are asking about hospitalization. Which statement by the client's mother indicates to the PN that she understands this disease? A) My daughter just doesn't have much of an appetite right now. B) She is trying to punish me for my recent divorce from her father. C) She sees herself as being very fat even though she is severely underweight. D) There really isn't anything to worry about since most girls want to be very thin.
C) She sees herself as being very fat even though she is severely underweight.
A male client who has lost his job calls the clinic and tells the practical nurse (PN), "I feel so overwhelmed that I've decided to take a handful of sleeping medicine I bought over the counter at the drugstore. I wish I didn't have to do it, but there's no other way." The PN asks several questions and learns that his wife is in the next room. How should the PN respond? A) Convince him to drive himself to the hospital. B) Go to his home address and take him to the hospital. C) Keep him on the phone while another nurse calls the police. D) Persuade him to call his wife to the phone.
D) Persuade him to call his wife to the phone.
During a routine prenatal clinic visit, the practical nurse (PN) is assessing a pregnant female client who expresses fears of spousal abuse. Which information should the PN provide to facilitate client disclosure? A) Provide her with a reflection of her apparent unhappiness and uncertainty about pregnancy. B) Tell her that spousal abuse can be supported by evidence of old fractures seen on x-rays. C) Encourage her to share incidents of past abuse so her personal safety can be addressed. D) Share with client that her situation is not unique and abuse often increases with pregnancy.
D) Share with client that her situation is not unique and abuse often increases with pregnancy.
The practical nurse (PN) is inquiring about coping strategies with a male client who is admitted for alcohol abuse. The client tells the PN that his job skills and communication skills are his best assets and support. Which additional information should the PN obtain about maladaptive mechanisms? A) Family support. B) Self indulgence. C) Financial security. D) Daily stressors.
B) Self indulgence.
A client with delusions of persecution has been refusing all hospital meals for the last 3 days and tells the practical nurse that the food contains poison. What action should the PN implement? A) Taste a small portion of the food in front of the client. B) Obtain a prescription for nasogastric nutrition. C) Provide foods in the original closed containers. D) Allow the client to place a food order for delivery.
C) Provide foods in the original closed containers.
An older male client who has vision and hearing problems is admitted after a combative incident with his caregivers. Which intervention should the practical nurse (PN) implement when providing basic care? A) Ask the healthcare provider for a prescription to use restraints. B) Perform tasks quickly to reduce risks to caregivers. C) Explain to the client that this is unacceptable behavior. D) Obtain the client's attention and consent before starting care.
D) Obtain the client's attention and consent before starting care.
Which nursing intervention is best to help a female client with progressive memory deficit? A) Promote the client's sense of humor by telling jokes and discussing cartoons. B) Avoid frustrating the client by performing routine activities of daily living for her. C) Stimulate the client intellectually by bringing new topics to her attention. D) Assist the client to perform simple tasks by giving step-by-step directions.
D) Assist the client to perform simple tasks by giving step-by-step directions.
A woman arrives at the clinic with multiple bruises. The practical nurse (PN) who has cared for her on previous similar visits is concerned about her safety. Which question should the PN ask the client to determine if she is a victim of domestic violence? A) How are things in your home life? B) Why do you stay in your situation? C) What did you do that caused your partner to hit you? D) Do you feel it is healthy to remain a battered victim?
A) How are things in your home life?
A male client who is diagnosed with schizophrenia, catatonic type, is admitted to the mental health unit and does not verbally communicate to any of the staff. His wife states that he became increasingly anxious, withdrawn, and stayed in bed staring at the wall since his recent job promotion. Which nursing diagnosis should the PN implement for this client ? A) Impaired verbal communication related to severe anxiety. B) Personal identity disturbance related to workplace stress. C) Fear of responsibility related to a promotional opportunity. D) Ineffective individual coping related to unresolved conflict.
A) Impaired verbal communication related to severe anxiety.
A client diagnosed with Stage 3 Alzheimer's disease is experiencing difficulty toileting appropriately. What instruction is best for the practical nurse (PN) to provide the family? A) Label the client's bathroom door. B) Place the client in disposable diapers. C) Make sure the client does not eat nonfood items. D) Question the client often about the urge to void or defecate.
A) Label the client's bathroom door.
A client with a long history of alcoholism is admitted with pneumonia and begins to manifest fine tremors, tachycardia, hypertension, and confusion. Which additional finding is most important for the practical nurse (PN) to report immediately? A) Tactile hallucinations. B) Amnesia with short-term memory loss. C) Confabulation and word substitution. D) Ataxia and nystagmus.
A) Tactile hallucinations.
A man who has been admitted numerous times for alcohol detoxification is found wandering in the street and is unable to identify himself or his home address. He is manifesting ataxia, nystagmus, and confusion and has a blood alcohol level (BAL) of 0.29%. Which prescribed medication should the practical nurse (PN) administer to prevent Korsakoff's psychosis? A) Thiamine. B) Benzodiazepines. C) Glucose solution. D) Haloperidol (Haldol).
A) Thiamine.
The nurse who is leading a group therapy session is called to manage a unit emergency and assigns the practical nurse (PN) as the leader of the group. During the therapeutic session, a client challenges the PN as the leader. Which response should the practical nurse (PN) communicate? A) You are saying that I should not be the leader? B) Let's vote and see who should be the leader. C) So, you do not like me or my leadership style? D) You will not be the group leader ever.
A) You are saying that I should not be the leader?
Which finding should the practical nurse (PN) identify in a 10-year-old client who is diagnosed with attention deficit hyperactivity disorder (ADHD)? A) Crying when separated from parents and siblings. B) Refusing to pick up toys as instructed by parents. C) Fascination with spinning and moving toys and objects. D) Inability to concentrate long enough to complete school work.
D) Inability to concentrate long enough to complete school work.
Which drug is commonly prescribed for a client with attention-deficit hyperactivity disorder (ADHD)? A) Haloperidol (Haldol). B) Imipramine (Tofranil). C) Fluphenazine (Prolixin). D) Methylphenidate (Ritalin).
D) Methylphenidate (Ritalin).
